Against what is the tick vaccination useful? And against what not?

The tick vaccination protects against the TBE viruses. It does not protect against Lyme disease. In contrast to TBE, Lyme disease can be treated in time with antibiotics. Ticks can very rarely transmit other diseases, but the TBE vaccination does not protect against these either.

What is TBE?

TBE stands for "tick-borne encephalitis" and is a disease that can be transmitted by tick bites. The disease occurs in two phases: One to two weeks after infection by the ticks, flu-like symptoms may appear. For most, however, nothing happens.
In the second phase the disease develops negatively in 5 to 15 % of sufferers and the central nervous system is affected. This is manifested by headaches, photophobia, dizziness, difficulty concentrating and walking. These symptoms can last for several months.
Some patients also experience paralysis of the arms, legs or facial nerves. These paralyses can cause permanent disabilities. In a very few cases, the TBE infection even leads to death.
TBE cannot be treated causally. There are only drugs that improve the symptoms.

What is Lyme disease?

Besides TBE, Lyme disease is the second major disease transmitted by ticks. There is no vaccination against Lyme disease, but the disease can be treated with antibiotics if detected in time. A detailed explanation of the disease is available e.g. from the FOPH (Lyme disease) or Beobachter (Lyme disease).

Can children get the tick vaccine? From what age can I be vaccinated?

The tick vaccination can be carried out in the pharmacy from the age of 16. At the doctor's children can be vaccinated earlier.

How often do I have to be vaccinated against TBE?

Three times:

  1. Vaccination: Basic immunisation is best done in the winter.
  2. Vaccination: 1 to 3 months after the first vaccination. With the second vaccination, a vaccination protection of 87% is already achieved.
  3. Vaccination: 5 to 12 months after the second vaccination

With the three vaccinations you are protected for at least ten years with a vaccination protection of 99%.
In addition to the normal vaccination schedule, there is also the rapid schedule at the beginning of the warm season. With this scheme, the second vaccination follows after only 14 days and the third vaccination after 5 to 12 months. With the rapid schedule, vaccine protection after the second is 85%.
Annotation: Percentages may vary by vaccine manufacturer. To be on the safe side, you can briefly ask which vaccine is being used when you get vaccinated.

Tick vaccination yes or no: Should I get vaccinated?

Since the beginning of 2019, almost the whole of Switzerland has been classified as risk area for TBE. Therefore, vaccination is recommended for all persons who spend time outdoors for professional or private purposes, especially in the forest.
Anyone considering tick vaccination should ask themselves the following questions:

  • Am I often outdoors or in tick areas?
  • Do I have the possibility to protect myself well against the ticks e.g. by sprays or clothes?
  • What is the relationship between side effects and TBE?

Farmers or foresters, for example, spend a lot of time outdoors. The same is true for climbers or hikers. Both groups probably cannot always protect themselves sufficiently against ticks. Therefore, they are at great risk of being bitten more often by ticks. So the likelihood of getting the TBE viruses increases significantly in them. Vaccination is strongly recommended for these groups, as the likelihood of problematic side effects is massively lower than the risk of contracting TBE.
Those who only move around town might refrain from vaccinating. However, they must always protect themselves well, especially in recreational areas close to the city.
For the relationship between adverse events and TBE disease, the figures in the next two questions can be used as a guide. Statistically, severe neurological side effects occur very rarely with vaccination (1 in 70,000 to 1 in 1 million doses). The risk of dying from a tick bite, on the other hand, is 1 in 33,000 to 500,000. Permanent disabilities, on the other hand, are much more common. The calculation is thus made simple: Those who enjoy outdoor activities are much more likely to contract TBE than the very rare neurological side effects of vaccination.

What are the side effects of tick vaccination and how long do they last?

The vaccination is generally very well tolerated. However, side effects can still occur, but most of them pass after a short time (about two days):

  • Local reactions at the injection site (in about 30% of people): Redness, small swelling, pain
  • General reactions (in about 30% of people): Headache, fatigue, nausea, muscle and joint pain, very rarely fever
  • Allergic reactions (anaphylactic shock): 1-2 cases per 1 million doses. Shock occurs very quickly and can be treated.
  • Severe neurological side effect: These are very rare (1 in 70,000 to 1 in 1 million doses).

In our opinion, the severe neurological side effects are the only ones that need to be looked at more closely. The other side effects pass quickly and are not problematic.
So what are the neurological side effects? Since they are extremely rare, they are described rather generally: For example, severe headaches, visual disturbances, temporary loss of sensation, seizures or paralysis. Extremely rarely, inflammation of the nerves or brain has also occurred after vaccination. The Federal Commission on Immunisation issues writes in this regard: “Given the rarity of such events, an assessment of causal relationship is difficult, but must be considered to exist in individual cases."
These side effects are therefore extremely rare, not clearly attributable and transient. Thus, the benefits of tick vaccination outweigh any side effects.

What is the risk of getting the TBE virus?

Approx. 1 % of ticks in risk areas carry the TBE virus. So the risk of getting the virus from a sting (or bite) is at most 1 in 100, because not all stings transmit the virus. For the majority of those affected, nothing happens after the sting. In 5 to 15% of infected persons, the central nervous system is attacked, which can lead to permanent disabilities. Fatal is about 1% of cases with neurological symptoms. (Numbers via infovac.ch)

  • maximum 1 TBE virus transmission per 100 tick bites
  • 5 to 15 cases with central nervous system infestation per 10,000 tick bites (1 to 3 cases per 2000 bites)
  • 1-3 deaths per 200,000 tick bites

According to Swiss Paediatrics one in 1000 to 5000 people in risk areas contracted TBE with neurological symptoms. Accordingly, the risk of dying from a tick bite would be 1 in 33,000 to 500,000.

How expensive is the tick vaccination?

The cost of a complete tick vaccination is CHF 202.05 at our pharmacy.

Cost Vaccination Service: CHF 20.00, this includes documentation, administration and entry in the vaccination card
Costs vaccine: CHF 47.35
As the vaccination has to be given three times, the costs at the pharmacy are 3 × CHF 20.00 + 3 × 47.35, i.e. CHF 202.05.

How long does the tick vaccination last? When do I have to refresh the tick vaccination?

With the tick vaccination you are protected for at least 10 years. Then you should, according to the recommendation of the FOPH, refresh your vaccination. A single vaccination is sufficient for this.

Where can I get vaccinated against ticks?

For example, at our Central Apotheke Thalwil (Tick Vaccination Service). With us, the vaccination takes about 15 minutes. You can conveniently register in advance and have no waiting time.

This text was last updated on 13th August 2020. Quality assured by Carmelina Pacifico, Federally Certified Pharmacist ETH.

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